Table 1.
SBRT reirradiation for spinal metastases
| Clinical trial | No. patients/treatments | Dose 1st RT course (median) | Interval (median months) | Reirradiation TD/fraction number (median) | Accumulated dose to spinal cord EQD2 (median) | Planning | Set-up/imaging | Follow-up (months) | Myelopathy | Local/pain control |
|---|---|---|---|---|---|---|---|---|---|---|
|
Milker-Zabel et al. 2003 |
18/19 |
38Gy |
17.7 |
39.6Gy |
n/s |
ss-IMRT |
Stereotactic |
12.3 |
0% |
94.7% |
|
Mahan et al. 2005 |
8/8 |
30Gy |
n/s |
30Gy/15 |
48Gy |
Tomotherapy |
Daily MV-CT |
15.2 |
0% |
100% at time of fu |
|
Sahgal et al. 2009 |
25/37 |
36Gy |
11 |
24Gy/3 |
n/s |
Cyberknife |
kV tracking |
7 |
0% |
70% |
|
Choi 2010 |
42/51 |
40Gy |
19 |
20Gy/2 |
76Gy |
Cyberknife |
kV tracking |
7 |
n=1 G4 |
73% |
|
Sterzing et al. 2010 |
36/36 |
36.3Gy |
17.5 |
34.8Gy/11 |
46.5Gy |
Tomotherapy |
Daily MV-CT |
7.5 |
0% |
1-year 76% |
| |
2-years 63% |
|||||||||
|
Damast et al. 2010 |
95/97 |
30Gy |
n/s |
20-30Gy/5 |
54.3Gy |
IMRT |
Daily portal images or CBCT |
12.1 |
0% |
1-year 66% |
|
Garg et al. 2011 |
59/63 |
30Gy |
n/s |
27-30Gy/3-5 |
n/s |
IMRT |
Daily CT on rails or CBCT |
13 |
n=2 G3 peripheral nerve injury |
76% |
|
Mahadevan et al. 2011 |
60/81 |
30Gy |
20 |
24-30Gy/3-5 |
n/s |
Cyberknife |
kV tracking |
12 |
n=3 persistent radicular pain |
93% |
| |
n=1 lower-extremity weakness |
|
||||||||
| Chang et al. 2012 | 49/54 | 39.2Gy | 25 | 27Gy/3 | 83.4Gy | Cyberknife | kV tracking | 17.3 | 0% | 79% |
Abbreviations: RT = radiotherapy; TD = total dose; n/s = not specified; ss-IMRT = single shot intensity-modulated radiation therapy; MV-CT = megavolt computed tomography; kV = kilo Volt; CBCT = cone beam computed tomography; IMRT = intensity modulated radiation therapy; G = grade.